Oklahoma Insurance Department offers Medicare Assistance Program

One month into the Open Enrollment Period, Oklahoma’s Medicare recipients are taking advantage of the Oklahoma Insurance Department’s Medicare Assistance Program.

Through the first four weeks of Open Enrollment, MAP counselors received 3,379 calls.

“The high call volume shows that Oklahomans have a lot of questions about Medicare,” said Oklahoma Insurance Commissioner John D. Doak. “We’re happy to help in any way we can.” MAP counselors are trained to provide unbiased information about Medicare products. Through the first four weeks of enrollment, they heard many of the same concerns. Here’s a list of the most frequently asked questions and their answers.

Q. If I don’t want to change anything, do I have to do anything?

A. No, you do not have to do anything if you are not making changes. However, there are a couple of things to consider: Is the plan you were on last year still going to be offered in the coming year? Have the prescription drugs you take changed from last year? Also, think about what changes have occurred with your current plan, such as monthly premiums and prescription drug coverage. If you’re on a Medicare Advantage plan, make sure the doctors and hospitals you want to use are still part of your plan’s network of providers. You will also want to compare other plans to determine if any offer better coverage and/or a lower monthly premium.

Q. If I’m still working, do I have to enroll in Part B?

A. If you or your spouse are still working full-time and have group health insurance coverage through the employer, you do not have to enroll in Medicare Part B when you turn 65. You can delay your enrollment until you or your spouse retire and no longer have your group health insurance coverage. However, there are a couple of points to keep in mind: If your employer has less than 20 employees, you will need to take out Part B, which becomes your primary coverage and your employer coverage becomes secondary. Also, if you receive your prescription drug coverage through the employer group health plan, you need to make sure that coverage is considered “creditable” by Medicare. You can check your annual notice or ask the benefits administrator where you work.

Q. Is my Part D Plan the right one?

A. You will need to do a plan comparison to determine the answer to this question and that can be done using a tool called Plan Finder, which is available at www.medicare.gov. This tool guides you through the process of reviewing your current coverage and comparing it to the other options available to you. If you are not comfortable doing the review yourself or you would like someone to review the information with you, contact the Medicare Assistance Program at the OID at 800-763-2828. Trained counselors are available to talk to you over the phone or set a face-to-face appointment. Local agencies providing counseling are also available, if you would prefer to talk to someone in your area.

Q. My Medicare Advantage Plan is no longer offered – what do I do?

A. If your Medicare Advantage or Part D prescription drug plan will not be available to you next year, contact MAP to do a plan review to help you decide what actions you may want to take. You may need to choose another Medicare Advantage plan in your area or go back to traditional Medicare and pick up a prescription drug plan. Also, if the Medicare Advantage plan in which you are enrolled discontinues service in your geographic area, you have an opportunity to choose a Medicare Supplement policy from plans A, B, C, F, K, and L, and you have guarantee issue rights. That means you can purchase any Medigap policy that is available in Oklahoma and the company cannot deny you or charge you more for pre-existing or current health issues.

Q. Do I have to change plans because of the Affordable Care Act?

A. The Affordable Care Act has had no impact on the current process of selecting your own coverage. So far, the impact of the act has been to provide coverage for preventive services and assistance for beneficiaries whose drug costs are high enough to put them in the coverage gap, also known as the donut hole.

Medicare open enrollment began Oct. 15 and ends Dec. 7. During open enrollment, Medicare-eligible consumers can sign up for coverage as well as change their options for the coming year. Oklahomans with questions about Medicare can call MAP counselors at (800) 763-2828.